National Technical Assistance and Evaluation Center for Systems of Care.
While interagency collaboration can produce tremendous benefits for children, families, and communities (Hodges et al., 1999), efforts to establish partnerships can encounter obstacles (Robinson et al., 2003). The experiences of the nine grant communities involved in the Improving Child Welfare Outcomes Through Systems of Care initiative provide useful information for administrators and stakeholders about the challenges and strategies associated with implementing the principle of interagency collaboration.
In working to build interagency collaboratives as critical elements of systems change, grantee communities identified and addressed three significant challenges: limited resources, significant time requirements, and staff turnover.
1. Limited Resources of Systems of Care Partners
Challenges. Grantees were unanimous in pointing to a lack of resources and constraints on time and funding as impediments to interagency activities. Nationwide, State and local agencies face limited human service budgets, in some instances compounded by State budget deficits. In many cases, funding is siloed and restricted to particular services. Regardless of individual perspectives on the benefits of working together, limited resources increased the challenges at all levels for building interagency collaboration.
Strategies. While grantees faced challenges defining, prioritizing, and addressing the needs of children and families served, they mitigated the effects of limited resources by sharing an overall vision, mission, and objectives. Through this unifying approach, grantees identify common populations, respond to needs of the populations, and adopt policies that can be carried out through interagency collaboration. By targeting overlapping populations, grant communities are better able to identify duplicative or conflicting approaches to meeting service needs. Additionally, the collaborative process allows for braided funding to support practices geared toward serving common populations.
- In New York City, a small group conducted systematic outreach to encourage other partner agencies to participate in systems of care activities. One-to-one conversations with key agency personnel helped build trust, encouraged communication, and clarified the benefits of collaboration to the partners.
- In Colorado, the State legislature passed House Bill 1451, which strongly recommends that all human service agencies create memorandums of understanding that detail how they will work together to blend financial and service resources, encourage greater input from families in shaping their case plans, and identify annual benchmarks they will work toward on behalf of children and families involved with two or more human service agencies.
- In Alamance County, North Carolina, a yearly retreat for systems of care stakeholders provides a forum for reviewing annual data on individual children and families served to identify service gaps and determine policy issues to be addressed in the coming year.
2. Building Interagency Collaboration Takes Time
Challenges. Building collaboration is a developmental process that takes time and considerable effort. Communities developing a system of care must allow sufficient time to establish structural elements such as cross-agency governance, formal collaborative groups at the supervisory and service levels, and formal interagency agreements. Moreover, communities need time to identify collaborative-specific staff, secure funds for flexible use, and develop a commitment to group decision-making and problem solving (Hodges et al., 1999). Maintaining and deepening partnerships require progressive renewal of the commitment to common goals.
Strategies. Because collaboration requires a deep commitment over time, grant communities worked to ensure that collaborating partners were on board early on in the process and throughout the evolution of the system of care. By bringing collaborators together on a regular basis to review progress and revise strategies, communities increased trust among the organizations involved and gradually deepened their commitment to mutual goals and the change process.
- Cherokee County, Kansas, collaborated with both State child welfare personnel and local evaluators to complete a strategic planning process that resulted in specific goals, objectives, and a timeline for systems of care efforts and activities. Two meetings a month, which took place over an 18-month period, were designated for completing the process.
- Contra Costa County, California, reviews its System Improvement Plan monthly with its policy council by analyzing data on progress and barriers to meeting goals and objectives. Based on the review, the council revises and creates activities. The council reviews the strategic plan annually.
- Grantees agreed that recognizing incremental achievements in transforming their systems of care was essential for maintaining morale and measuring progress. Examples of incremental achievements included appointing the first family member to the governing body and completing important systems of care training.
- In grant communities that had previous systems of care for youth with emotional disturbances (Contra Costa County) and/or a State-mandated systems of care approach (Oregon), the existing governance structure supported interagency collaboration and facilitated progress for the child welfare sponsored initiative. In Contra Costa County, where this grant followed two prior systems of care grants focused on children's mental health, the governance committee leadership transitioned its focus to child welfare and identified new target populations that were sufficiently inclusive so all stakeholders would continue to benefit. The governance committee now guides efforts funded through other sources as well. Similarly, the North Carolina Collaboration for Families, Youth, and Children, originally focused on developing a system of care for children and youth with serious emotional disturbances and their families, has expanded its mission to include children and families involved with the child welfare system.
- Grant communities without an established system of care devoted the initial years to building an interagency governance and collaborative case review structure that featured meaningful participation by families. This consisted of gathering all relevant partner agencies and families to create a common vision, mission, and strategic plan for their child welfare target populations. In some instances, developing the initial interagency agreement within 3â€“6 months gave partners the opportunity to experience the collaborative process without a long-term commitment, and then take additional steps to extend the partnership. In Cherokee County, the development of a vision, mission, and strategic plan took a little over 1 year to craft with technical assistance from outside the partnership. In New York City, the CRADLE in Bedford-Stuyvesant partnered with One City One Community, a cross-system effort designed to identify and eliminate policy and service barriers for children and families, to form a larger, more inclusive collaborative.
3. Staff Turnover in Key Positions
Challenges. Involving cross-agency partners, key community members, family partners, and evaluators from the earliest planning stages can make infrastructure change both easier and more sustainable. Additionally, communities with stable leadership have historically been more successful developing a solid infrastructure and realizing system change. When key individuals resign, retire, or transfer, they often take with them institutional knowledge, interpersonal relationships, valuable experience, and credibility. For example, annual job rotations in the Oregon grant, and lack of a State administrative champion, compromised progress. In addition, frontline staff turnover is a particularly significant challenge to sustaining interagency collaboration for systems change.
Strategies. To address turnover, the grant communities worked to retain institutional memory for systems of care by hiring former child welfare staff as consultants. Because line staff turnover in child welfare is high, the grant communities developed continuous training programs for middle managers and frontline staff on key principles and strategies, thereby promoting institutional memory and culture change. Sites with limited history with systems of care made good tactical use of training and technical assistance offered through the grant to build capacity and support for interagency collaboration.
- To reduce expenditures, Oregon offered a retirement option for many older management level employees. Several of these experienced child welfare professionals were subsequently hired as contract employees to guide the systems of care demonstration in participating counties. They brought with them not only great knowledge but also considerable respect from internal and cross-agency colleagues.
- In New York City and North Carolina, senior middle managers helped stabilize the early systems of care effort and offered guidance both within the child welfare agency and across the partner agencies, with great success. New York and Pennsylvania developed continuous training processes for managers and frontline staff designed to reinforce systems of care principles and keep frontline staff and supervisors aware of potential opportunities for collaboration.
- Early in the grant program, the National Technical Assistance and Evaluation Center for Systems of Care presented a Community Leadership Institute and Family Summit to give systems of care leaders a better understanding of the complexities of systems change. This was especially helpful to communities without existing systems of care infrastructures.